腰椎退变性疾病手术治疗策略.docxVIP

腰椎退变性疾病手术治疗策略 李友文曾建洪陈渝彭旭 (四川省内江市东兴区人民医院四川内江641100) 【摘 要】目的：探讨腰椎退变性疾病手术方式选择。方法：回顾性总结 并分析2010.1-2014.6期间，我院选择性应用经椎间孔腰椎椎间融合术(TLIF)与腰 椎后路椎间融合术(PLIF)治疗腰椎退变性疾病85例，其中TLIF组55例、PLIF组 30例，通过比较其手术时间、术中出血量、手术前后椎间高度变化情况、植骨 融合率，并采用JOA下腰疼评分标准、视觉模拟评分法(Visual analogscale, VAS) 进行功能评分来评价手术疗效。结果：TLIF与PLIF比较，手术时间较短、出血量 较少、并发症发牛率较低；而椎间高度恢复与植骨融合率均良好，两组间无明显 差别；JOA腰痛疾患评分与VAS视觉模拟评分：两组术后随访都明显好于术前, 但两组之间无明显差异。结论：TLIF和PLIF均是治疗腰椎退行性变疾病的有效手 术方式，但应根据患者的具体情况，严格掌握两种术式的适应证，选择最合适的 手术方式，或者将两种术式结合应用，以取得最佳疗效。 【关键词】腰椎退变性疾病；经椎间孔腰椎椎间融合术；腰椎后路椎间融合 术； 【中图分类号】R68 【文献标识码]A 【文章编号】1004-6194 (2015 ) 01-0007-02 Lumbar degenerative disease, surgical treatment strategy Li You-wen Ceng Jianhong Chen Yu Peng Xu (sichuan neijiang large district peoples hospital, 641100) [Abstract】Objective: To investigate the operation mode selection of lumbar degenerative disease. Method: a retrospective summary and analysis during the period of the 2010.1-2014.6, selective use in our hospital the intervertebral foramen lumbar in terbody fusio n (TLIF) and posterior lumbar interbody fusi on (PLIF) treatment of lumbar degenerative disease of 85 cases, of which the TLIF group 55 cases, PLIF group 30 cases, by compare the operation time, intraoperative blood loss, opera廿on before and after change of intervertebral height, bone graft fusion rate, and the JOA score low back pain score standard，visual analogue score (visual analogscale, VAS) of scoring functions to evaluate the surgical results. Result： TLIF and PLIF compared shorter operation time, bleeding quantity is less, complications occurrenee rate is low; and recovery of the height of intervertebral space and bone graft fusion rate was good, between the two groups no significant differenee; JOA score and vas visual analogue score: two groups of postoperative follow-up was better in the preoperative, but between the two groups no significant differenee. Conclusion: the TLIF and PLIF are effective surgical procedure for the treatment of lumbar degenerative disease, but it should be ac